BACKGROUND: Optimal indications for living donor liver transplantation (LDLT) for patients with hepatocellular carcinoma (HCC) have yet not been established. The aim of the present study was to determine optimal criteria including categories outside the Milan criteria (MC) and still with a predictably good outcome. PATIENTS AND METHODS: Between February 1999 and December 2007, 136 patients with HCC underwent LDLT. Based on preoperative imaging studies, 74 patients met the MC and 62 did not. RESULTS: Overall patient survival rate at 5 years was 70%. Patients who exceeded MC but presented with <or=10 tumors and all <or=5 cm in diameter (n = 33) displayed similar 5-year recurrence rate to those within MC (7 vs. 10%). Based on the results of multivariate analysis of risk factors for recurrence, we defined new criteria as n <or=10 and all <or=5 cm and PIVKA-II <or=400 mAU/ml. The 5-year recurrence rate for the 83 patients who met the new criteria was significantly lower than for the 44 patients who exceeded them (5 vs. 61%, p < 0.0001). Similarly, patients who met the new criteria showed a significantly better 5-year survival rate (87 vs. 37%, p < 0.0001). CONCLUSION: The selection criteria may be safely extended up to n <or=10 and all <or=5 cm in diameter and PIVKA-II <or=400 mAU/ml with acceptable outcomes. (c) 2007 S. Karger AG, Basel.
BACKGROUND: Optimal indications for living donor liver transplantation (LDLT) for patients with hepatocellular carcinoma (HCC) have yet not been established. The aim of the present study was to determine optimal criteria including categories outside the Milan criteria (MC) and still with a predictably good outcome. PATIENTS AND METHODS: Between February 1999 and December 2007, 136 patients with HCC underwent LDLT. Based on preoperative imaging studies, 74 patients met the MC and 62 did not. RESULTS: Overall patient survival rate at 5 years was 70%. Patients who exceeded MC but presented with <or=10 tumors and all <or=5 cm in diameter (n = 33) displayed similar 5-year recurrence rate to those within MC (7 vs. 10%). Based on the results of multivariate analysis of risk factors for recurrence, we defined new criteria as n <or=10 and all <or=5 cm and PIVKA-II <or=400 mAU/ml. The 5-year recurrence rate for the 83 patients who met the new criteria was significantly lower than for the 44 patients who exceeded them (5 vs. 61%, p < 0.0001). Similarly, patients who met the new criteria showed a significantly better 5-year survival rate (87 vs. 37%, p < 0.0001). CONCLUSION: The selection criteria may be safely extended up to n <or=10 and all <or=5 cm in diameter and PIVKA-II <or=400 mAU/ml with acceptable outcomes. (c) 2007 S. Karger AG, Basel.
Authors: Andreas Andreou; Safak Gül; Andreas Pascher; Wenzel Schöning; Hussein Al-Abadi; Marcus Bahra; Fritz Klein; Timm Denecke; Benjamin Strücker; Gero Puhl; Johann Pratschke; Daniel Seehofer Journal: HPB (Oxford) Date: 2014-09-28 Impact factor: 3.647
Authors: Melanie B Thomas; Deborah Jaffe; Michael M Choti; Jacques Belghiti; Steven Curley; Yuman Fong; Gregory Gores; Robert Kerlan; Phillipe Merle; Bert O'Neil; Ronnie Poon; Lawrence Schwartz; Joel Tepper; Francis Yao; Daniel Haller; Margaret Mooney; Alan Venook Journal: J Clin Oncol Date: 2010-08-02 Impact factor: 44.544
Authors: Sudeep Tanwar; Shahid A Khan; Vijay Paul Bob Grover; Catherine Gwilt; Belinda Smith; Ashley Brown Journal: World J Gastroenterol Date: 2009-11-28 Impact factor: 5.742
Authors: Sunyoung Lee; Kyoung Won Kim; Woo Kyoung Jeong; Myeong-Jin Kim; Gi Hong Choi; Jin Sub Choi; Gi-Won Song; Sung-Gyu Lee Journal: Eur Radiol Date: 2019-08-30 Impact factor: 5.315